Antenatal and neonatal antecedents of learning limitations in 10-year old children born extremely preterm

Early Hum Dev. 2018 Mar;118:8-14. doi: 10.1016/j.earlhumdev.2018.01.020. Epub 2018 Feb 7.


Background: Children born extremely preterm are at increased risk of learning limitations.

Aim: To identify the antecedents of learning limitations of children born extremely preterm.

Study design: Prospective observational study from birth to age 10 years. Variables entered into the multinomial logistic regression analyses were ordered temporally, with the earliest occurring predictors/covariates of each learning limitation risk entered first and not displaced by later occurring covariates.

Subjects: 874 children who were born before the 28th week of gestation.

Outcome measures: A reading limitation was defined as a score one or more standard deviations below the expected mean on the WIAT-III Word Reading and a mathematics limitation was defined as a similarly low score on the Numerical Operations component.

Results: 56 children had a "reading ONLY" limitation, 132 children had a "math ONLY" limitation and 89 children had "reading AND math" limitations. All risk profiles included an indicator of socioeconomic disadvantage (e.g., mother's "racial" identity and eligibility for government-provided health care insurance), an indicator of newborn's immaturity/vulnerability (e.g., high illness severity score, receipt of hydrocortisone, and/or ventilator-dependence at 36 weeks post-menstruation), and all but the math only limitation included an indicator of fetal growth restriction and inflammation (i.e., pregnancy urinary tract infection or late ventilator-dependence).

Conclusions: The themes of socioeconomic disadvantage and immaturity/vulnerability characterize all three risk profiles, while the themes of fetal growth restriction and inflammation are characteristic of a reading limitation only, and the reading and math limitations entity.

Keywords: Extremely preterm; Learning disabilities; Mathematics; Reading; School performance; Special educational needs.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Academic Performance*
  • Adult
  • Child
  • Female
  • Fetal Diseases / epidemiology*
  • Humans
  • Infant, Extremely Premature / growth & development*
  • Infant, Newborn
  • Infant, Premature, Diseases / epidemiology*
  • Learning Disabilities / epidemiology*
  • Male
  • Pregnancy
  • Reading
  • Socioeconomic Factors